Excludes1 pair
D55- vs D59.2
D55 and D59.2 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.
The official note, declared on D55
drug-induced enzyme deficiency anemia (D59.2)
D55
Anemia due to enzyme disorders
Not billable
- Chapter 3
- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
- Section
- D55-D59
D59.2
Drug-induced nonautoimmune hemolytic anemia
Billable
- Chapter 3
- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
- Section
- D55-D59
Use when the record says
- Drug-induced enzyme deficiency anemia
Indexed under
- Anemia › enzyme-deficiency, drug-induced
- Nonautoimmune hemolytic anemia › drug-induced
- Disease, diseased › nonautoimmune hemolytic › drug-induced
- Anemia › deficiency › enzyme › drug-induced (hemolytic)
- Anemia › hemolytic › due to › drugs (nonautoimmune)
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027